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What Is Involved in the Management of Hypercholesterolemia?

B. Chisholm
B. Chisholm

The management of hypercholesterolemia usually involves non-drug measures initially, such as diet and lifestyle changes, and then may include the addition of medication, of which there are a number of different classes. Both the patient and the doctor involved in the management of hypercholesterolemia play an important role in the long-term lowering and maintenance of cholesterol levels.

Hypercholesterolemia is an ever-increasingly common condition worldwide and refers to high cholesterol levels. Cholesterol is divided into three main groups: high density lipoproteins (HDL), low density lipoproteins (LDL) and triglycerides, synthesized in the liver and, in the correct amounts, essential for normal functioning of the body. Simply put, the HDL is referred to as "good cholesterol" and LDL and triglycerides as "bad cholesterol." Hypercholesterolemia may occur as a result of genetic disorders or as a result of a lifestyle and age.


Too much cholesterol can cause blockages in the blood vessels resulting in high blood pressure and, more seriously, heart attacks or stroke. It is for this reason that early intervention and management of hypercholesterolemia is vital. It is diagnosed by doing a simple blood test to establish the lipid profile. This will allow the doctor to determine a specific patient-by-patient plan for the management of hypercholesterolemia.

The most important part of any plan for the management of hypercholesterolemia is lifestyle changes. This includes a change in diet: decreasing the intake of high cholesterol foods, such as those with trans fats found in foods like fast foods, margarine and cookies. Healthier fats include olive oil and canola oil. Increased fiber intake and fresh fruit and vegetables, replacing red meat with healthier fish or lean meat and reducing alcohol intake can all help to reduce cholesterol levels. Weight loss and exercise are also recommended.

If lifestyle changes alone don't reduce the cholesterol levels sufficiently, medication may need to be taken. There are a number of different drugs used in the management of hypercholesterolemia, each with a different mechanism of action and each affecting the different lipids to varying degrees. The prescribing doctor will choose the most suitable drug by looking at each patient's lipid profile, clinical history and other factors.

The management of hypercholesterolemia requires commitment from the patient from both a non-drug and drug measure point-of-view to lower cholesterol levels effectively and maintain them at a healthy level. The drugs used to treat high cholesterol may cause adverse effects or interact with other medications and these should be discussed with the prescribing doctor. The control of cholesterol is a long-term process and may require lifetime treatment.

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